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Emergency Medicine/Global Medicine
Medical Emergency
Patient assessment
Last Updated: October 1, 2015
Emergency Diagnosis and Treatment
What are the types of patient assessment?
Patient 60-second assessment by call center/Internet/telemedicine.
Patient 60-second on-the-spot diagnosis and treatment.
Patient 60-second assessment in trauma.
Patient 10-minutes assessment in a medical emergency room.
Patient-focused history and physical exam.
Comprehensive patient assessment.

What is a medical emergency?
If a human being has any problem, symptom, complaint, or situation listed below, it is a medical emergency.

What best describes the problem, symptom, complaint, or situation in the list?


What type of assessment does this patient need?


What will happen if this medical condition is left without treatment?


The individual can die.
The individual can have a disability.
The individual can have severe pain.
The individual can have irreparable harm.

Does this situation need a doctor?


What should be displayed on an emergency medical record?
Details of the patient.
Details of the diagnosing and treating medical doctor.

Details of the patient.

What should be your first question in case a patient is referred to you?

Patient 60-second assessment by call center/Internet/telemedicine.

Where is the patient now?


How old is the patient?


What is the gender of the patient?


Who is reporting this emergency?


What are the sources of medical history?


Patient not responding to medical history questions.
Community member.
Police officer.
Referral from medical doctor.

How much time has elapsed from the start of the emergency until now?


Does one individual or many individuals have medical emergencies at this location?


How many individuals have medical emergencies at this location?


A medical emergency with an individual victim.
A multiple casualty incident.
Do you think this is a multiple causality incident?
If it is a multiple causality incident, the guidelines are different.

Check vital signs, mobility, and survival needs.

Consciousness of a human being has to be included in vital signs.

Vital Signs

Consciousness, pulse, blood pressure, respiratory rate, temperature.

Consciousness is extremely essential in reaching a correct diagnosis and treatment.

What are the vital signs on the date and time of diagnosis and treatment?

Date: Time: Consciousness: Pulse: Blood pressure: Respiratory rate: Temperature:
______ ______ ______ ______ ______ ______ ______
______ ______ ______ ______ ______ ______ ______
______ ______ ______ ______ ______ ______ ______

How do you categorize the condition of the patient?



Is this an emergency?


What is the category of this emergency?


Is this a medical emergency?


In what type of setting does this patient need treatment?

Here are various examples.
Critical care
Coroner investigations
Emergency room health care
Emergency call center
Hospital ward
Home health care
Internet human health care services
Labor, delivery, and recovery rooms
Medicolegal cases
On-the-spot diagnosis and treatment
Operating rooms

Who has the duty to manage this emergency?


What best describes this human emergency?


Medical emergency
Surgical emergency
Trauma emergency
Pediatric emergency
Obstetrical/gynecological emergency
Medico legal case
Patient assessment
Patient 60-second on-the-spot diagnosis and treatment.

What problems, complaints, incidents, and issues need on-the-spot diagnosis and treatment?
Unconsciousness at a public location.
Sudden unconsciousness at home.
Survival Needs
Human Pregnancy Emergencies
Here are further guidelines.
What is the reason for consultation?


What seems to be the problem?


How much time has elapsed from the start of the emergency until now?


Does one individual or many individuals have medical emergencies at this location?


How many individuals have medical emergencies at this location?


What best describes your problem?


Patient Name:________________________

Referred by:_________________________

Mailing Address:_____________________


Your Email Address:__________________

Date of Birth:_______________________

Gender: Male Female

Primary Care Physician Name, Address and Phone:__________________

Emergency Contact Name:______________



Your Height:_________________________

Your Weight:_________________________


Black/African American
Pacific Islander


Can the patient talk?
Can the patient respond to verbal questions accurately?
Can the patient do spontaneous eye opening?
Does the patient respond to painful stimulus?
Is the patient conscious, oriented in time, space, and person?
Conscious means able to see, hear, and talk.
In pediatric patients younger than six months of age, the ability to make any verbal noise or cry is equivalent to talking.

What is the location of patient at the point of the medical emergency?
Can the patient talk relevant to age?
Can the patient walk relevant to age?
Are consciousness, pulse, blood pressure, and respiratory rate normal relevant to age?
What is the cause of the existing emergency medical scenario?

Here are further guidelines.

Here are further guidelines.

Emergency medical history

What questions should you ask in emergency medical history?

Survival Needs
Details of the diagnosing and treating medical doctor.

What is the name, date of birth, phone number, and other contact information of the person diagnosing and treating this patient?


What is the date and time you are diagnosing and treating this patient?


What is the location of the patient at the time you are diagnosing and treating this patient?


What best describes the location of diagnosis and treatment of this case?
1. On-the-spot diagnosis and treatment.
2. Emergency room diagnosis and treatment.
3. In the hospital diagnosis and treatment.
4. Long-distance health care advice.
5. Other
Can you reach a correct diagnosis and treatment of a human being?


What is the diagnosis of this patient?


How did your reach this diagnosis?


What is the treatment for this patient?


Does the patient need to be transferred to a medical emergency room?


In America up to February 12, 2012, most emergency medical records did not have these facts.

In what emergency medical category do you fit the condition of the patient you are diagnosing and treating on this date and time?

Undetermined, Good, Fair, Serious, Critical.

If on-the-spot diagnosis of a patient declared in serious or critical condition, arrange a bed in the Intensive Care unit.

Date of Examination:_________________________

Physician Name:_________________________

Physician Address:_________________________

Is it a Medical Emergency?


In what type of setting does this patient need treatment?


Do any recent causes lead to this problem; for example, trauma, missed medication, inadequate survival needs, stress, or other issue?


What are further details?


Does any past medical history lead to this problem?


Is there any recent history within past few minutes or hours of any of the following:
1.Unconsciousness at a public location.
2.Sudden unconsciousness at home.
4.Survival needs issues.


If there is even one recent history of the above, on the spot diagnosis and treatment is required.

Is the victim's condition life or limb threatening?


Could the victim's condition worsen and become life or limb-threatening on the way to the hospital?


Could moving the victim cause further injury?


Does the victim need the skills or equipment of paramedics or emergency medical technicians?


Would distance or traffic conditions cause a delay in getting the victim to the hospital?


What have been his activities for the last 10 years?


Does the individual use or abuse any of these substances?


Is the individual on any medication?


Questions doctor on duty needs to answer.

Is it a medical emergency?


What is the diagnosis?


In what setting/location does this medical condition need treatment?
Treatment required on the spot.
Treatment required in the medical emergency room.
Treatment required in the intensive care unit.
Treatment required in the ward.
Treatment required in the operating room.
Treatment required at home.
Treatment required Internet health care.
Treatment required in OPD consultation.


What treatment do you recommend for this patient?


What are other treatment options for this patient?
No other treatment option.
Other treatment options are enumerated.


How do you do a quick assessment, diagnosis, and treatment of a conscious patient?
Are you the person reporting a medical emergency for yourself?
How do you do a quick assessment, diagnosis, and treatment of an unconscious patient?
Are all vital signs normal? Can the person move relevant to age? Has the person been provided with survival resources? Does the person or caregiver complaint of anything? Are these justified complaints?

Medical emergencies.
What are examples of emergency relevant to an individual?
What are various symptoms, signs, statements, questions, issues, and histories that should raise suspicion of a medical emergency?

There are at least 155 such symptoms, signs, statements, questions, issues, histories, and scenarios.
  1. Agitated Patient (Acute stress reaction.)

  2. Attempted suicide.

  3. Attempted homicide.

  4. Abuse.

  5. Abdominal Pain.(Stomach pain)

  6. Altered sensorium.

  7. Any sudden or severe pain.

  8. Animal bites (may require rabies or tetanus shot).

  9. Armed Robbery.

  10. Allergic reactions.

  11. Breathing difficulties.

  12. Behavior that is dangerous to self or others and cannot be managed.

  13. Bleeding from any orifice or any part of human body that will not stop.

  14. Bleeding which does not stop after applying pressure.

  15. Being beaten by someone.

  16. Burns.

  17. Bites.

  18. Bloody Sputum

  19. Broken bones.

  20. Behavior-related emergencies.

  21. Change in mental status (such as unusual behavior, confusion, and difficulty arousing).

  22. Changes in vision.

  23. Chest pain.

  24. Choking.

  25. Cough with fever.

  26. Coughing up or vomiting blood.

  27. Confusion or changes in mental status

  28. Cuts and abrasions.

  29. Chest or upper abdominal pain or pressure lasting two minutes or more.

  30. Diarrhea

  31. Difficulty breathing.

  32. Difficulty speaking.

  33. Disoriented.

  34. Difficulty getting up.

  35. Difficulty in passing urine.

  36. Difficulty in passing feces.

  37. Domestic Violence

  38. Dramatic change in facial expression or demeanor.

  39. Drowning or near drowning

  40. Dental emergencies.

  41. Emergency diagnosis and treatment in neonatal period.

  42. Emergency diagnosis and treatment after neonatal period.

  43. Earaches and ear infections.

  44. Electrical injury shock.

  45. Emergency Food

  46. Environmental factors (hostile environment).

  47. Evidence of pain or discomfort that is not easily explained.

  48. Fainting.

  49. Fever.

  50. Foreign bodies in nose or ears.

  51. Fainting or loss of consciousness.

  52. Fainting, sudden dizziness, weakness, seizure.

  53. Feeling of committing suicide or murder.

  54. Fever with breathlessness. (Onset of fever of 101 degrees or higher.)

  55. Functional impairment (not taking care of self. inability to gain relevant skills and knowledge relevant to age).

  56. Human Rights Violations

  57. Head or spine injury.

  58. Head injury.

  59. Human Pregnancy Emergencies

  60. Hypothermia - frostbite.

  61. Head pain that lasts longer than five minutes.

  62. Holding abdomen.

  63. Infection at injury site.

  64. Intentional enforced harms.

  65. Involuntary admission to a psychiatric facility

  66. Loss of consciousness.

  67. Loss of consciousness not related to a seizure

  68. Loosening of social inhibitions.

  69. Likely to be harmful to self or others.

  70. Low abdominal pain.

  71. Medicine overdose.

  72. Major burns.

  73. Medicolegal cases

  74. Nosebleeds.

  75. New or sudden onset of incontinence.

  76. No pulse

  77. Onset of limping, inability to walk, or difficulty in movement.

  78. Pain.

  79. Palpitations.

  80. Poisoning.

  81. Poisoning including overdoses of medication.

  82. Persistent or severe vomiting.

  83. Persistent unexplained fever even with Tylenol use.

  84. Puncture wounds.

  85. Personality disorders (harmful to others). Panic attacks.

  86. Psychosis(delusions, hallucinations, catatonia, thought disorder, loss of contact with reality).

  87. Rape.

  88. Pregnancy-related emergencies.

  89. Possible serious bone fractures.

  90. Rapid change in behavior or an increase in challenging behavior such as aggression or self-injurious behavior.

  91. Rashes.

  92. Rash lasting several days or getting worse.

  93. Scratching (Intense)

  94. Severe sore throat/difficulty swallowing.

  95. Survival Needs

  96. Starvation

  97. Suicidal feelings.

  98. Surgical Emergencies

  99. Significant trauma (to the head, stomach, chest)

  100. Syncope.

  101. Seizures.

  102. Seizure lasting over five minutes or continuous seizures

  103. Severe asthmatic attack when prescribed medications do not work

  104. Severe injuries as a result of accidents such as broken bones

  105. Severe reactions to a medication with difficulty breathing or itching.

  106. Severe reactions to insect bites or other previously unknown allergic reactions

  107. Sore throat & fever

  108. Sunburn.

  109. Severe neck or back injury.

  110. Sexual intercourse due to conspiracy.

  111. Severe or persistent vomiting.

  112. Severe or persistent vomiting or diarrhea.

  113. Severe headache.

  114. Severe burns.

  115. Severe pain in any part of the body that does not subside.

  116. Serious drug reactions with psychiatric or non-psychiatric medications.

  117. Syncope or unconsciousness.

  118. Sudden or severe pain.

  119. Sudden loss of vision.

  120. Suicidal or homicidal feelings.

  121. Sudden asthma attack that does not stop.

  122. Sudden numbness or not being able to move an arm, leg, or one side of the body.

  123. Sever headache with fever or vomiting.

  124. Sudden injury or trauma due to a motor vehicle crash, burns, smoke inhalation, near drowning, wound, etc.

  125. Substance abuse.

  126. Sudden severe pain anywhere in the body.

  127. Sudden dizziness, weakness, or change in vision.

  128. Swallowing a poisonous substance.

  129. Shock symptoms, e.g., confusion, disorientation, cool/clammy, pale skin.

  130. Severe or persistent vomiting or diarrhea.

  131. Sleeping most of the day; unusual difficulty in arousing; unusual fatigue.

  132. Stroke or suspected stroke (paralysis, numbness, confusion)

  133. Swelling that is new

  134. Trauma with unconsciousness.

  135. Trauma with cuts, sprains, or abrasions.

  136. Trauma with open fracture.

  137. Trauma with pain on mobility.

  138. Trauma with swelling.

  139. Unable to detect breathing

  140. Unconsciousness.

  141. Unconsciousness with diabetes.

  142. Unconsciousness at a public location.

  143. Sudden unconsciousness at home.

  144. Unable to move

  145. Uncontrolled bleeding

  146. Upper abdominal pain.

  147. Uncontrolled bleeding.

  148. Unusual abdominal pain.

  149. Unusual or persistent abdominal pain.

  150. Unexplained stupor, drowsiness or disorientation.

  151. Violence

  152. Violence or other rapid changes in behavior.

  153. Vomiting

  154. Vomiting or coughing blood.

  155. Vomiting and diarrhea.
What will happen if you do not diagnose and treat a medical emergency properly?
It can lead to death.
It can lead to disability.
It can lead to other harms.
It can lead to medical malpractice.
It can lead to legal malpractice.
Last Updated: October 1, 2015